SKIN May 2022 Volume 6 Issue 3 (c) 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine. 225 RESEARCH LETTER Residency Program Websites as an Avenue Towards Increasing Diversity and Inclusion in Dermatology: A Cross-Sectional Analysis of Program Websites Ramon Govea, BS,1 Lauren C. Hollins, MD2 1 Pennsylvania State College of Medicine Hershey, PA 2 Department of Dermatology- Penn State Hershey Medical Center Hershey, PA In 2016, a call to action was made for increasing ethnic diversity in the field of dermatology1. From pre-medical programs to national medical organizations, initiatives have been constructed to address the lack of physicians from underrepresented minority (URM) groups. Despite these efforts, only 4.6% and 6.6% of dermatology trainees in 2019-2020 are of “Black or African American” and “Hispanic, Latino, or of Spanish Origin” respectively2. More efforts are needed if the field wishes to have a similar demographic representation to the nation, which is 13.4% Black or African American and 18.5% Latino or Hispanic3. Faculty appointments held by URMs at academic centers are also declining4. Thus, new methods of recruitment and retention in academia need to be explored. Increasing applicant awareness of dermatology’s efforts to promote diversity and inclusion (D&I) can have the potential to attract more URM applications. One often utilized resource for information on residency programs is their website. Our study analyzes current dermatology residency program (DRP) websites to determine if D&I efforts and ABSTRACT Background: In recent years, dermatology as a field has identified a paucity in diversity. Multiple projects at different institutional levels were initiated to address this. One area of interest is recruitment of underrepresented minorities (URMs) in medicine at the residency level. This study investigates how many dermatology residency programs display their diversity and inclusion (D&I) efforts on their official website. Methods: 140 US Dermatology residency program (DRP) websites were analyzed for presence of D&I action items at all, and then specifically within their curriculum, goals, mission statements. The websites were reviewed for the presence of zero tolerance policies as well as targeted resources made available for URMs in the residency program. Results: As of December 2020, only 45/140 (32%) of residency programs mention D&I on their official websites. The least represented action item across all DRP websites is the zero-tolerance policy for discrimination (3.6%). Conclusions: Most dermatology residency programs do not mention D&I on their websites. This can be a budget-friendly and effective method to recruit more diverse applicants to dermatology. As residency application seasons continue virtually, the program websites might be increasingly utilized as a source of information. INTRODUCTION SKIN May 2022 Volume 6 Issue 3 (c) 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine. 226 commitments are mentioned on these websites. In December 2020, the American Association of Medical College’s (AAMC) Careers in Medicine database was used to find all ACGME-accredited DRPs. Of these 143 programs, 140 had official websites. The primary outcome measured was the mentioning of D&I within mission statements, objectives, curricula, as well as trainee resources offered by the DRP. Proper judgement was used to determine whether the item was promoting any of the following: a diverse workforce, decrease in patient care disparities, increase in access or equitable patient care, focus on skin of color. The word “diversity” did not have to be present to meet the requirements. The presence of a zero-tolerance policy for discrimination was measured as well. Program websites have multiple methods for distributing information. This study measured information provided directly through text on the DRP website. Information conveyed through other formats, such as videos and PDF files, was excluded. Among the 143 listed DRPs in the AAMC database, 140 (98%) were analyzed. Figure 1 summarizes the results regarding each specific category where D&I was mentioned by the DRPs website. Broad language regarding D&I was mentioned in 45/140 (32%) websites. This percentage only decreased when looking for more specific action items. The least represented action item across all DRPs is the zero-tolerance policy for discrimination. The field of dermatology is actively pursuing a more diverse workforce1,5, acknowledging the benefits of having physicians that reflect the demographics of our patient population. One approach to increasing diversity is with recruitment of URMs medical students. Residency programs use their website as a tool to provide information to prospective applicants. This study examined which ACGME-accredited DRPs actively list their commitment to D&I. The data gathered shows that DRPs are currently underutilizing their website as a method to recruit URMs. Only 32% of DRPs mention D&I on their program websites. Even less DRP websites have D&I embedded in their program goals or curriculum (28% and 14% respectively). Now, with the SARS-CoV-2 pandemic forcing virtual interview processes, it is imperative that residency programs use their website to recruit and display information that could be important to URMs when developing their rank lists6. In conclusion, we encourage all DRPs to update their websites to demonstrate their commitment to D&I, as a simple, cost- effective method that could lead to an increase the number of URM residents in the field of dermatology. This study presents limitations. By excluding information conveyed in formats other than direct text, some programs appeared to have less D&I items. METHODS RESULTS DISCUSSION CONCLUSION SKIN May 2022 Volume 6 Issue 3 (c) 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine. 227 Figure 1. Percent of dermatology websites mentioning diversity and inclusion Future studies are needed to determine how these changes correlate with URM applications and diversity in residency programs. Conflict of Interest Disclosures: None Funding: None Corresponding Author: Lauren C. Hollins, MD 500 University Drive Hershey, PA 17033 Office: 717-531-6049 Email: lhollins@pennstatehealth.psu.edu References: 1. Pandya AG, Alexis AF, Berger TG, Wintroub BU. Increasing racial and ethnic diversity in dermatology: A call to action. J Am Acad Dermatol. 2016 Mar;74(3):584-7. doi: 10.1016/j.jaad.2015.10.044. Epub 2016 Jan 8. PMID: 26774427. 2. Table B5. Number of Active MD Residents, by Race/Ethnicity, (Alone or In Combination) and GME Specialty." AAMC. 18 Aug. 2021. Web. Association of American Medical Colleges. 3. Quick Facts: United States. Race and Hispanic Origin. Version: July 1, 2021. Website. United States Census Bureau. 4. Lett LA, Orji WU, Sebro R. Declining racial and ethnic representation in clinical academic medicine: A longitudinal study of 16 US medical specialties. PLoS One. 2018 Nov 16;13(11):e0207274. doi: 10.1371/journal.pone.0207274. PMID: 30444928; PMCID: PMC6239326. 5. Pritchett EN, Pandya AG, Ferguson NN, Hu S, Ortega-Loayza AG, Lim HW. Diversity in dermatology: Roadmap for improvement. J Am Acad Dermatol. 2018 Aug;79(2):337-341. doi: 10.1016/j.jaad.2018.04.003. Epub 2018 Apr 10. PMID: 29653209. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% MentionedZero Tolerance PolicyEmbedded in Mission Statement, Objectives, or Goals Embedded in Curriculum Targeted in Resources Offered Diversity and Inclusion on Dermatology Residency Program Websites Present Absent mailto:lhollins@pennstatehealth.psu.edu SKIN May 2022 Volume 6 Issue 3 (c) 2022 THE AUTHORS. Published by the National Society for Cutaneous Medicine. 228 6. Bernstein, Simone A (10/2020). "Graduate Medical Education Virtual Interviews and Recruitment in the Era of COVID-19.". Journal of graduate medical education (1949-8357), 12 (5), p. 557.